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Updated: Apr 27, 2026
Author Spotlight: Decellularization-Based Quantification of Skeletal Muscle Fatty Infiltration
Published on: June 9, 2023
Intramuscular fat in ambulant young adults with bilateral spastic cerebral palsy
Jonathan J Noble1, Geoffrey D Charles-Edwards, Stephen F Keevil
1Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, 4th Floor, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, United Kingdom. jonathan.noble@gstt.nhs.uk.
Insights
Young adults with bilateral spastic cerebral palsy (BSCP) exhibit higher intermuscular and intramuscular fat in leg muscles compared to typically developing peers. This increased fat infiltration may impact function and cardiovascular health.
Area of Science:
- Biomedical Engineering
- Human Physiology
- Medical Imaging
Background:
- Individuals with bilateral spastic cerebral palsy (BSCP) often have reduced muscle size and strength.
- Previous research has not examined fat infiltration within the muscles of individuals with BSCP.
- Increased adiposity in skeletal muscles may have implications for functional capacity and cardiovascular health in BSCP.
Purpose of the Study:
- To investigate and compare intermuscular and intramuscular fat content in adults with BSCP versus typically developing (TD) adults.
- To explore potential differences in fat distribution related to Gross Motor Function Classification System (GMFCS) levels in BSCP.
Main Methods:
- Utilized multi-echo gradient echo chemical shift imaging (mDixon) to analyze 11 cm leg sections from 10 adults with BSCP (GMFCS I-III) and 10 TD adults.
- Quantified percentage intermuscular fat (IMAT) and intramuscular fat (IntraMF).
- Calculated subcutaneous fat to muscle volume ratio (SF/M).
Main Results:
- Adults with BSCP demonstrated significantly higher IntraMF across all measured muscles compared to TD peers (p = 0.001-0.013).
- IntraMF varied significantly across GMFCS levels, with GMFCS level III showing the highest content.
- IMAT was also significantly elevated in the BSCP group (p < 0.001).
- No significant differences in SF/M were found between BSCP and TD groups.
Conclusions:
- Young adults with BSCP have greater intermuscular and intramuscular fat infiltration than their TD counterparts.
- The functional and cardio-metabolic consequences of this increased fat infiltration require further investigation.
Background:
It is known that individuals with bilateral spastic cerebral palsy (BSCP) have small and weak muscles. However, no studies to date have investigated intramuscular fat infiltration in this group. The objective of this study is to determine whether adults with BSCP have greater adiposity in and around their skeletal muscles than their typically developing (TD) peers as this may have significant functional and cardio-metabolic implications for this patient group.
Methods:
10 young adults with BSCP (7 male, mean age 22.5 years, Gross Motor Function Classification System (GMFCS) levels I-III), and 10 TD young adults (6 male, mean age 22.8 years) took part in this study. 11 cm sections of the left leg of all subjects were imaged using multi-echo gradient echo chemical shift imaging (mDixon). Percentage intermuscular fat (IMAT), intramuscular fat (IntraMF) and a subcutaneous fat to muscle volume ratio (SF/M) were calculated.
Results:
IntraMF was higher with BSCP for all muscles (p = 0.001-0.013) and was significantly different between GMFCS levels (p < 0.001), with GMFCS level III having the highest IntraMF content. IMAT was also higher with BSCP p < 0.001). No significant difference was observed in SF/M between groups.
Conclusion:
Young adults with BSCP have increased intermuscular and intramuscular fat compared to their TD peers. The relationship between these findings and potential cardio-metabolic and functional sequelae are yet to be investigated.
